A Cure for Diabetes? An Anti-Fat Pill? What Science Has in Store this Decade

Stomach stapling as a diabetes cure? An anti-fat pill? Science is making progress against obesity and the health problems it creates.

By Tara Parker-Pope

Photo: Plamen Petkov

The year began with what sounded like fantastic news: In January the U.S. Centers for Disease Control and Prevention reported that the national obesity rate appears to have stopped rising. But before you tear into a celebratory box of cookies, here's the reality check, courtesy of David Ludwig, MD, director of the obesity program at Children's Hospital Boston: A national weight plateau "doesn't mean we've turned the corner on the epidemic," he says. "It just shows we're not getting worse."

Nearly 34 percent of American adults and 17 percent of kids are still classified as obese. And because being overweight is a primary risk factor for type 2 diabetes, those numbers portend a looming medical crisis. Already, more than 20 million adults in the United States have the disease. However, scientists are discovering new ways to fight both epidemics—from pills that melt away pounds to a surgery that can reverse diabetes. And public health officials are championing the most radical weapon of all: prevention.

For years, pharmaceutical companies have been striving to create a drug that would take the work out of losing weight. These days the most promising candidate appears to be Qnexa—a once-a-day pill that combines two drugs: phentermine, an appetite suppressant, and topiramate, which is used to treat epilepsy seizures and to prevent migraines, and has the happy side effect of making patients feel full. In trials, patients taking the highest dose lost 11 percent of their body weight in one year compared with a 2 percent loss in the placebo group. Two other medications in clinical trials are Contrave, which reduces food cravings, and Lorcaserin, which activates chemicals in the brain that control appetite. In separate studies, patients using the drugs lost an average of 3 to 5 percent of their body weight.

Yet it's unlikely that any of these medications will be a true magic pill to make you smaller. For starters, they don't produce enough weight loss (a 250-pound woman who lost 11 percent of her weight would still weigh 223 pounds), and lingering concerns about side effects are likely to impede the FDA approval process. (Topiramate, one of the components in Qnexa, has been linked with "foggy" thinking.) Most worrisome is the possibility that serious problems—like the heart valve disease that was linked to fen-phen—may not show up until a drug is in widespread use.

For now, the closest thing to an obesity-fighting magic bullet is bariatric surgery, such as gastric bypass, commonly known as stomach stapling. But researchers are finding that the procedure offers a powerful benefit beyond weight loss: In one of the most important diabetes advances since the discovery of insulin, recent studies suggest that the surgery may be able to cure the disease.